NSG 430 FINAL EXAM: ADULT HEALTH
NURSING II QUESTIONS AND ANSWERS
1. A patient in the ICU with ARDS is on mechanical ventilation with high PEEP. Which
assessment finding is most concerning regarding PEEP complications?
A. Decrease in cardiac output
B. Increase in arterial oxygen saturation
C. Decrease in peak inspiratory pressure
D. Respiratory alkalosis
Answer: A
Conceptual Explanation: High levels of Positive End-Expiratory Pressure (PEEP) can
increase intrathoracic pressure, leading to decreased venous return to the heart, which
subsequently lowers cardiac output and blood pressure.
2. A nurse is caring for a patient experiencing hypovolemic shock. Which physiological change
occurs during the compensatory stage of shock?
A. Decreased heart rate
B. Increased urine output
,C. Decrease in respiratory rate
D. Vasoconstriction due to catecholamine release
Answer: D
Conceptual Explanation: In the compensatory stage, the sympathetic nervous system
releases catecholamines (epinephrine and norepinephrine), causing vasoconstriction to
maintain blood pressure to vital organs.
3. A patient presents with a MAP of 55 mmHg and a CVP of 2 mmHg. Which intervention
should the nurse anticipate first?
A. Administration of a vasodilator
B. Furosemide 40mg IV push
C. Rapid intravenous fluid bolus
D. Starting a dopamine infusion
Answer: C
Conceptual Explanation: A low MAP and low Central Venous Pressure (CVP) indicate
hypovolemia. The priority is volume resuscitation before considering vasopressors.
4. Which rhythm is characterized by a lack of P-waves, an irregular rhythm, and a high risk for
thromboembolism?
A. Ventricular Tachycardia
B. Atrial Fibrillation
, C. First-degree Heart Block
D. Sinus Bradycardia
Answer: B
Conceptual Explanation: Atrial Fibrillation (AFib) is characterized by disorganized
electrical activity in the atria (no P-waves) and an irregular ventricular response, leading to
blood stasis and clot formation.
5. The nurse observes a ‘sawtooth’ pattern on the ECG monitor. Which dysrhythmia is the
patient experiencing?
A. Premature Ventricular Contractions
B. Ventricular Fibrillation
C. Atrial Flutter
D. Supraventricular Tachycardia
Answer: C
Conceptual Explanation: Atrial Flutter typically demonstrates a classic ‘sawtooth’ pattern
of F-waves on an EKG.
6. A patient with a traumatic brain injury has an ICP of 22 mmHg. Which position is most
appropriate for this patient?
A. Trendelenburg
B. Supine with legs elevated
NURSING II QUESTIONS AND ANSWERS
1. A patient in the ICU with ARDS is on mechanical ventilation with high PEEP. Which
assessment finding is most concerning regarding PEEP complications?
A. Decrease in cardiac output
B. Increase in arterial oxygen saturation
C. Decrease in peak inspiratory pressure
D. Respiratory alkalosis
Answer: A
Conceptual Explanation: High levels of Positive End-Expiratory Pressure (PEEP) can
increase intrathoracic pressure, leading to decreased venous return to the heart, which
subsequently lowers cardiac output and blood pressure.
2. A nurse is caring for a patient experiencing hypovolemic shock. Which physiological change
occurs during the compensatory stage of shock?
A. Decreased heart rate
B. Increased urine output
,C. Decrease in respiratory rate
D. Vasoconstriction due to catecholamine release
Answer: D
Conceptual Explanation: In the compensatory stage, the sympathetic nervous system
releases catecholamines (epinephrine and norepinephrine), causing vasoconstriction to
maintain blood pressure to vital organs.
3. A patient presents with a MAP of 55 mmHg and a CVP of 2 mmHg. Which intervention
should the nurse anticipate first?
A. Administration of a vasodilator
B. Furosemide 40mg IV push
C. Rapid intravenous fluid bolus
D. Starting a dopamine infusion
Answer: C
Conceptual Explanation: A low MAP and low Central Venous Pressure (CVP) indicate
hypovolemia. The priority is volume resuscitation before considering vasopressors.
4. Which rhythm is characterized by a lack of P-waves, an irregular rhythm, and a high risk for
thromboembolism?
A. Ventricular Tachycardia
B. Atrial Fibrillation
, C. First-degree Heart Block
D. Sinus Bradycardia
Answer: B
Conceptual Explanation: Atrial Fibrillation (AFib) is characterized by disorganized
electrical activity in the atria (no P-waves) and an irregular ventricular response, leading to
blood stasis and clot formation.
5. The nurse observes a ‘sawtooth’ pattern on the ECG monitor. Which dysrhythmia is the
patient experiencing?
A. Premature Ventricular Contractions
B. Ventricular Fibrillation
C. Atrial Flutter
D. Supraventricular Tachycardia
Answer: C
Conceptual Explanation: Atrial Flutter typically demonstrates a classic ‘sawtooth’ pattern
of F-waves on an EKG.
6. A patient with a traumatic brain injury has an ICP of 22 mmHg. Which position is most
appropriate for this patient?
A. Trendelenburg
B. Supine with legs elevated
